REVIEW   Free access

Minerva Anestesiologica 2019 April;85(4):401-11

DOI: 10.23736/S0375-9393.18.13179-8

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

The Italian law on informed consent and advance directives: its impact on intensive care units and the European legal framework

Giuseppe R. GRISTINA ¹ ✉, Lucia BUSATTA ², Mariassunta PICCINNI ³

¹ Member of the Italian Society of Anesthesia and Intensive Care, Study Group on Bioethics (Società Italiana di Anestesia Analgesia Rianimazione e Terapia Intensiva SIAARTI - Gruppo di Studio per la Bioetica), Rome, Italy; ² Department of Public, International and EU Law, University of Padua, Padua, Italy; ³ Department of Political Science, Law and International Studies University of Padua, Padua, Italy

The Italian Parliament has recently approved a law on informed consent, advance directives and advance care planning. The law also deals with health care proxy and health care decisions for minors and adults who are not able to give consent. The Italian law arrived quite late in comparison with other European countries. After several years of debate on the need to approve such a law, the focus has now shifted to the assessment of the legislative provisions and their impact on clinical practice. In this article, the authors firstly offer an overview of the findings from the empirical research regarding the use of the different legal tools in the field of intensive care medicine; secondly, they present the tools now provided by law no. 219/2017 particularly with regard to the decision-making processes in the Intensive Care Unit (ICU); thirdly, the authors offer a comparison between the new Italian law and other European legal orders, with special reference to France, Spain, Germany and England. The aim of the article is to assess the degree of innovation of the law vis-à-vis the previous framework.

KEY WORDS: Advance directives; Advance care planning; Health care; Proxy; Intensive Care Unit